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Sparse trees hide the entryway. A descending wooden passageway leads down to a brightly lit welcome zone. There is a operating ward, outfitted with gurneys, cardiac monitors and ventilators. Plus shelves full of healthcare supplies, drugs and organized stacks of extra garments. In a staff room with a laundry appliance and hot water heater, physicians keep an eye on a display. The screen reveals the movements of enemy surveillance UAVs as they zigzag in the sky above.

Medical personnel at an subterranean hospital look at a monitor showing enemy kamikaze and surveillance UAVs in the region.

Welcome to Ukraine’s covert below-ground hospital. This center began operations in the eighth month and is the second such installation, located in eastern Ukraine close to the frontline and the urban area of a key location in the Donetsk region. “Our facility sits six meters under the earth. This is the most secure way of delivering care to our injured soldiers. And it keeps healthcare workers safe,” said the clinic’s surgeon, Major Oleksandr Holovashchenko.

This medical station handles 30-40 casualties a each day. Their conditions vary. Some have catastrophic limb trauma requiring amputations, or severe stomach wounds. Others can move on their own. The vast majority are the victims of enemy first-person view (FPV) aerial devices, which drop grenades with lethal accuracy. “Ninety per cent of our cases are from FPVs. We see few gunshot wounds. It’s an era of drones and a different kind of war,” the doctor said.

Major Oleksandr Holovashchenko at the subterranean installation for treating wounded troops in eastern Ukraine.

On one day last week, a group of three military members limped into the facility. The most lightly injured, twenty-eight-year-old Artem Dvorskyi, reported an FPV blast had torn a small hole in his limb. “Conflict is horrific. The guy next to me, Vasyl, was killed,” he said. “He fell down. Subsequently the Russians dropped a second explosive on him.” He continued: “Everything in the village is destroyed. We see UAVs all around and casualties. Ours and theirs.”

The soldier said his unit spent over a month in a forest area close to the city, which enemy forces has been trying to seize for many months. Sole access to get to their position was on foot. All supplies came by quadcopter: rations and water. A week after he was injured, he traveled five kilometers (about 3 miles), taking several hours, to where an military transport was able to pick him up. Upon arrival, a medic checked his physical condition. After treatment, a medical attendant gave him fresh non-military attire: a shirt and a pair of light-colored jeans.

The soldier, 28, said a first-person view drone ripped a minor injury in his lower limb.

A different casualty, thirty-eight-year-old a serviceman, recounted a drone blast had left him with concussion. “I was in a trench shelter. Suddenly it went dark. I lost sensation any feeling or hear anything,” he said. “I believe I was fortunate to remain alive. A relative has been lost. We face continuous detonations.” A builder employed in Lithuania, he said he had returned to his homeland and volunteered to serve days before the Russian leader's full-scale invasion in February 2022.

A third soldier, a serviceman, had been struck in the back. He expressed pain as medical staff placed him on a medical cot, took off a bloody dressing and treated his recent shrapnel wound. Covered in a foil blanket, he borrowed a cellphone to ring his sister. “A fragment of mortar hit me. The cause was a deflected projectile. I’m OK,” he informed her. What comes next for him? “To recover. This may require a several months. After that, to return to my unit. Our forces must protect our country,” he said.

Medical staff care for Taras Mykolaichuk, who was hit in the dorsal area by a fragment of mortar.

Since 2022, Russia has consistently attacked hospitals, health facilities, obstetric units and emergency vehicles. Per international monitors, over two hundred medical personnel have been killed in nearly two thousand assaults. This subterranean hospital is built from four steel bunkers, with wooden supports, soil and granular material placed above reaching ground level. It can withstand impacts from 152mm projectiles and even three 8kg TNT charges released by aerial means.

A major industrial group, which financed the building, intends to erect 20 units in total. The head of the nation's national security council and ex- defence minister, Rustem Umerov, said they would be “critically essential for preserving the lives of our armed forces and assisting troops on the battlefront.” The company described the project as the “largest-scale and challenging” it had undertaken after the enemy's military offensive.

An example of the facility's operating theatres.

Holovashchenko, said certain wounded soldiers had to endure delays hours or even multiple days before they could be evacuated due to the threat of aerial attacks. “We had a pair of severely injured patients who came at the early hours. I had to carry out a removal of both limbs on a patient. The soldier's bleeding control device had been applied for such an extended period there was no alternative.” How did he cope with traumatic operations? “My career in medicine for two decades. You have to focus,” he said.

Orderlies transported the soldier up the passage and into an emergency vehicle. The transport was parked beneath a shrub. He and the other soldiers were taken to the urban center of Dnipro for additional medical care. The underground hospital staff took a break. The hospital’s ginger cat, the mascot, padded up to the doorway to await the next arrivals. “We are open 24 hours a day,” the surgeon stated. “It doesn’t stop.”